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meta-analysis - Top 30 Publications

Tolerability and Efficacy of Ipragliflozin in The Management of Inadequately Controlled Type 2 Diabetes mellitus: A Systematic Review and Meta-analysis.

Ipragliflozin is a new antidiabetic agent that works through enhancing renal glucose excretion. We aim to synthesize evidence from published randomized controlled trials (RCTs) on the safety and efficacy of ipragliflozin in the management of type 2 diabetes mellitus (T2DM).

The effect of nonsteroidal anti-inflammatory drugs on bone healing in humans: A qualitative, systematic review.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used in postoperative pain management. While an increasing number of in vitro and animal studies point toward an inhibitory effect of NSAIDs on bone healing process, the few existing retro- and prospective clinical studies present conflicting data.

Shedding light on the association between repetitive negative thinking and deficits in cognitive control - A meta-analysis.

Individuals who experience recurrent negative thoughts are at elevated risk for mood and anxiety disorders. It is thus essential to understand why some individuals get stuck in recurrent negative thinking (RNT), whereas others are able to disengage eventually. Theoretical models propose that individuals high in recurrent negative thinking suffer from deficits in controlling the contents of working memory. Empirical findings, however, are inconclusive. In this meta-analysis, we synthesize findings from 94 studies to examine the proposed association between RNT and deficits in cognitive control. We included numerous effect sizes not reported in the primary publications. Moderator analyses tested the influence of variables, such as stimuli valence, cognitive control function (e.g., shifting, discarding), or type of RNT (i.e., rumination or worry). Results demonstrated an association between repetitive negative thinking and deficits in only one specific cognitive control function, namely difficulty discarding no longer relevant material from working memory (r = -0.20). This association remained significant after controlling for level of psychopathology. There was no substantial association between RNT and deficits in any other cognitive control function. All other moderators were not significant. We discuss limitations (e.g., primary sample sizes, reliability of paradigms) and highlight implications for future research and clinical interventions.

Rates and Factors Associated With Placebo Response in Trials of Pharmacotherapies for Nonalcoholic Steatohepatitis: Systematic Review and Meta-analysis.

Understanding the extent of the placebo effect in randomized controlled trials of studying nonalcoholic steatohepatitis (NASH) is important for optimal trial design, including sample size calculations and treatment endpoint definition.

Patient-Reported Outcomes and Endoscopic Appearance of Ulcerative Colitis-a Systematic Review and Meta-Analysis.

We aimed to evaluate the association of the patient-reported outcomes for rectal bleeding and stool frequency among patients with ulcerative colitis (UC) in endoscopic remission.

The effect of glucocorticoids on bone mineral density in patients with rheumatoid arthritis: A systematic review and meta-analysis of randomized, controlled trials.

The role of glucocorticoids in the treatment of rheumatoid arthritis (RA) is widely debated. Impairment of bone formation may be counter-balanced by reduced systemic inflammation. This review aims to assess the effect of prednisolone/prednisone on bone mineral density (BMD) in patients with RA analyzed in randomized, controlled trials.

A systematic review and meta-analysis of metal concentrations in canned tuna fish in Iran and human health risk assessment.

Human consumption of fish protein, including canned tuna fish, is increasing steadily worldwide. However, there are some concerns about the potential exposure to elevated concentrations of metals in canned tuna fish. Several studies have been conducted in Iran regarding the concentration of metals in seafood, including copper (Cu), selenium (Se), iron (Fe), zinc (Zn), mercury (Hg), lead (Pb), chromium (Cr), arsenic (As), nickel (Ni), tin (Sn), and cadmium (Cd) in canned tuna fish. The main aim of this study was to gather data from existing papers and to perform a meta-analysis of the pooled concentrations of metals to evaluate their non-carcinogenic and carcinogenic risks in children and adults consumers. Search was conducted retrieving data from the international biomedical databases with highly public access and consultation, e.g., Web of Science, PubMed, Science Direct, and Scopus, and national database (SID and Irandoc) between 1983 and November of 2017. Data from 23 articles and 1295 samples were assessed and extracted. The ranking order of metals based on mean concentrations (μg/g wet weight) were Fe (13.17) > Zn (9.31) > Se (2.23) > Al (1.8) > Cr (1.63) > Cu (1.52) > As (0.38) > Ni (0.33) > Pb (0.24) > Cd (0.14) > Hg (0.11) > Sn (0.1). Except for Cd and Se, concentrations of other metals in the canned tuna fish were lower than the limits recommended by the United States Environmental Protection Agency (USEPA), World Health Organization (WHO), Food and Agriculture Organization (FAO) and Iran National Standards Organization (INSO). The minimum and maximum target hazard quotient (THQ) for adults were 5.55E-5 for Al and 2.23E-08 for Cr. For children, they were 7.23E-05 for Al and 2.91E-08 for Cr. THQ, and total target hazard quotient (TTHQ) were ≤1.0 for adult and children consumers. The Incremental Lifetime Cancer Risk (ILCR) of As was 3.21E-5 in adults and 4.18E-5 in children. Adults and children that consume canned tuna fish in Iran are not at non-carcinogenic risk but have a carcinogenic risk due to As.

Deficits in saccades and smooth-pursuit eye movements in adults with traumatic brain injury: a systematic review and meta-analysis.

To conduct a review of literature and quantify the effect that traumatic brain injury (TBI) has on oculomotor functions (OM).

Novel genetic associations for blood pressure identified via gene-alcohol interaction in up to 570K individuals across multiple ancestries.

Heavy alcohol consumption is an established risk factor for hypertension; the mechanism by which alcohol consumption impact blood pressure (BP) regulation remains unknown. We hypothesized that a genome-wide association study accounting for gene-alcohol consumption interaction for BP might identify additional BP loci and contribute to the understanding of alcohol-related BP regulation. We conducted a large two-stage investigation incorporating joint testing of main genetic effects and single nucleotide variant (SNV)-alcohol consumption interactions. In Stage 1, genome-wide discovery meta-analyses in ≈131K individuals across several ancestry groups yielded 3,514 SNVs (245 loci) with suggestive evidence of association (P < 1.0 x 10-5). In Stage 2, these SNVs were tested for independent external replication in ≈440K individuals across multiple ancestries. We identified and replicated (at Bonferroni correction threshold) five novel BP loci (380 SNVs in 21 genes) and 49 previously reported BP loci (2,159 SNVs in 109 genes) in European ancestry, and in multi-ancestry meta-analyses (P < 5.0 x 10-8). For African ancestry samples, we detected 18 potentially novel BP loci (P < 5.0 x 10-8) in Stage 1 that warrant further replication. Additionally, correlated meta-analysis identified eight novel BP loci (11 genes). Several genes in these loci (e.g., PINX1, GATA4, BLK, FTO and GABBR2) have been previously reported to be associated with alcohol consumption. These findings provide insights into the role of alcohol consumption in the genetic architecture of hypertension.

Exposure to PM2.5 via vascular endothelial growth factor relationship: Meta-analysis.

This study investigated the association of PM2.5 exposure with VEGF by conducting a systematic review of existing literature and performing a meta-analysis. We searched all the studies published in the Cochrane Library, PUBMED, Embase, China National Knowledge Infrastructure China National Knowledge Infrastructure, and WanFang Electronic Database before June 2017. Finally six studies were identified. It confirmed that the increase in VEGF (β = 1.23 pg/ml, 95% CI: 0.45, 2.01) was significantly associated with the PM2.5 mass concentration of 10 μg/m3. Studies from Canada showed that PM2.5 exposure statistically elevated the level of VEGF level that an increase of 1.20 pg/ml (95% CI: 0.88, 1.52) in VEGF was associated with per 10 μg/m3 increase in PM2.5 concentration. Other subgroup analyses indicated that the effects of PM2.5 exposure on VEGF differed per the in different exposure assessment methods, study designs, and study settings. It was concluded that elevated VEGF levels was significantly positive associated with PM2.5 exposure. Exposure assessment methods and study countries were the major sources of heterogeneity among studies.

Comparative safety and effectiveness of perinatal antiretroviral therapies for HIV-infected women and their children: Systematic review and network meta-analysis including different study designs.

Nearly all newly infected children acquire Human Immunodeficiency virus (HIV) via mother-to-child transmission (MTCT) during pregnancy, labour or breastfeeding from untreated HIV-positive mothers. Antiretroviral therapy (ART) is the standard care for pregnant women with HIV. However, evidence of ART effectiveness and harms in infants and children of HIV-positive pregnant women exposed to ART has been largely inconclusive. The aim of our systematic review and network meta-analysis (NMA) was to evaluate the comparative safety and effectiveness of ART drugs in children exposed to maternal HIV and ART (or no ART/placebo) across different study designs.

Acellular pertussis vaccines effectiveness over time: A systematic review, meta-analysis and modeling study.

Acellular pertussis vaccine studies postulate that waning protection, particularly after the adolescent booster, is a major contributor to the increasing US pertussis incidence. However, these studies reported relative (ie, vs a population given prior doses of pertussis vaccine), not absolute (ie, vs a pertussis vaccine naïve population) efficacy following the adolescent booster. We aim to estimate the absolute protection offered by acellular pertussis vaccines.

BAHA Skin Complications in the Pediatric Population: Systematic Review With Meta-analysis.

Compare the incidence of skin and surgical site complications for children undergoing percutaneous and transcutaneous bone conduction implant (pBCI and tBCI) surgery via systematic review and meta-analysis of the available data.

Role of Cholecystectomy After Endoscopic Sphincterotomy in the Management of Choledocholithiasis in High-risk Patients: A Systematic Review and Meta-Analysis.

Endoscopic retrograde cholangiography and endoscopic sphincterotomy (ES) with subsequent cholecystectomy is the standard of care for the management of patients with choledocholithiasis. There is conflicting evidence in terms of mortality reduction, prevention of complications specifically biliary pancreatitis and cholangitis with the use of early cholecystectomy particularly in high-risk surgical and elderly patients.

Assessing Quality of Precut Sphincterotomy in Patients With Difficult Biliary Access: An Updated Meta-analysis of Randomized Controlled Trials.

It is generally accepted that precut sphincterotomy during endoscopic retrograde cholangiopancreatography (ERCP) increases the risk of pancreatitis. However, patients with difficult biliary access may be different. We implemented a meta-analysis to explore the effects of early and delayed precut sphincterotomy on post-ERCP pancreatitis in patients with difficult biliary access.

Diagnostic Accuracy of Point of Care Tests for Diagnosing Celiac Disease: A Systematic Review and Meta-Analysis.

To perform a systematic review and meta-analysis to estimate the overall diagnostic accuracy of point of care tests (POCTs) for diagnosing celiac disease (CD).

Homograft Versus Conventional Prosthesis for Surgical Management of Aortic Valve Infective Endocarditis: A Systematic Review and Meta-analysis.

Surgical management of aortic valve infective endocarditis (IE) with cryopreserved homograft has been associated with lower risk of recurrent IE, but there is equipoise with regard to the optimal prosthesis. This systematic review and meta-analysis were performed to compare outcomes between homograft and conventional prosthesis for aortic valve IE.

Are digital interventions for smoking cessation in pregnancy effective? A systematic review and meta-analysis.

Smoking in pregnancy remains a global public health issue due to foetal health risks and potential maternal complications. The aims of this systematic review and meta-analysis were to explore: (1) whether digital interventions for pregnancy smoking cessation are effective, (2) the impact of intervention platform on smoking cessation, (3) the associations between specific Behaviour Change Techniques (BCTs) delivered within interventions and smoking cessation, and (4) the association between the total number of BCTs delivered and smoking cessation. Systematic searches of nine databases resulted in the inclusion of 12 published articles (n = 2970). The primary meta-analysis produced a sample-weighted odds ratio (OR) of 1.44 (95% CI 1.04-2.00, p=0.03) in favour of digital interventions compared with comparison groups. Computer-based (OR=3.06, 95% CI 1.28 - 7.33) and text-message interventions (OR=1.59, 95% CI 1.07 - 2.38) were the most effective digital platform. Moderator analyses revealed seven BCTs associated with smoking cessation: information about antecedents; action planning; problem solving; goal setting (behaviour); review behaviour goals; social support (unspecified); and pros and cons. A meta-regression suggested that interventions using larger numbers of BCTs produced the greatest effects. This paper highlights the potential for digital interventions to improve rates of smoking cessation in pregnancy.

Pain and Surgical Outcomes Reporting After Laparoscopic Ventral Hernia Repair in Relation to Mesh Fixation Technique: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

The aim of this meta-analysis was to examine postoperative pain and surgical outcomes (operative time, hospital stay, the incidence of seroma and recurrence) with different mesh fixation methods following laparoscopic ventral hernia repair (LVHR).

Body Structure, Function, Activity, and Participation in 3- to 6-Year-Old Children Born Very Preterm: An ICF-Based Systematic Review and Meta-Analysis.

The World Health Organization's International Classification of Functioning, Disability and Health framework, Children and Youth Version (ICF-CY), provides a valuable method of conceptualizing the multidomain difficulties experienced by children born very preterm (VP). Reviews investigating motor outcomes at preschool age across ICF-CY domains are lacking.

Prevalence and prevention of oesophageal injury during atrial fibrillation ablation: a systematic review and meta-analysis.

Atrio-oesophageal fistula (AOF) is a potentially lethal complication of atrial fibrillation (AF) ablation. Many studies have evaluated the presence and prevention of endoscopically-detected oesophageal lesions (EDOL) as a proxy measure for risk of AOF. This systematic review and meta-analysis sought to determine the prevalence of EDOL and effectiveness of general preventive measures during AF ablation.

Three-Year Survival Comparison Between Transcatheter and Surgical Aortic Valve Replacement for Intermediate- and Low-Risk Patients.

Transcatheter aortic valve implantation is a suitable therapeutic intervention for patients deemed inoperable or high risk for surgical aortic valve replacement. Current investigations question whether it is a suitable alternative to surgery for intermediate- and low-risk patients. The following meta-analysis presents a comparison between transcatheter versus surgical aortic valve replacement in patients that are intermediate and low risk for surgery. Articles were collected via an electronic search using Google Scholar and PubMed. Articles of interest included studies comparing the survival of intermediate- and low-risk patients undergoing transcatheter aortic valve implantation to those undergoing surgical aortic valve replacement. Primary end points included 1-, 2-, and 3-year survival. Secondary end points included postintervention thromboembolic events, stroke, transient ischemic attacks, major vascular complications, permanent pacemaker implantation, life-threatening bleeding, acute kidney injury, atrial fibrillation, and moderate-to-severe aortic regurgitation. Six studies met the criteria for the meta-analysis. One- and two-year survival comparisons showed no difference between the two interventions. Surgical aortic valve replacement, however, presented with favorable 3-year survival compared with the transcatheter approach. Transcatheter aortic valve implantation had more major vascular complications, permanent pacemaker implantation, and moderate-to-severe aortic regurgitation rates compared with surgery. Surgical aortic valve replacement presented more life-threatening bleeding, acute kidney injury, and atrial fibrillation compared with a transcatheter approach. There was no statistical difference between the two approaches in terms of thromboembolic events, strokes, or transient ischemic attack rates. Surgical aortic valve replacement presents favorable 3-year survival rates compared with transcatheter aortic valve implantation.

Mental practice for upper limb rehabilitation after stroke: a systematic review and meta-analysis.

Mental practice (MP) is usually provided in combination with other therapies, and new developments for neurofeedback to support MP have been made recently. The objectives of this study were to evaluate the effectiveness of MP and to investigate the intervention characteristics including neurofeedback that may affect treatment outcome. The Cochrane Central Register of Controlled Trials, PubMed, Embase, KoreaMed, Scopus, Web of Science, PEDro, and CIRRIE were searched from inception to March 2017 for randomized controlled trials to assess the effect of MP for upper limb rehabilitation after stroke. Fugl-Meyer Assessment (FMA) was used as the outcome measure for meta-analysis. Twenty-five trials met the inclusion criteria, and 15 trials were eligible for meta-analysis. Among the trials selected for meta-analysis, MP was added to conventional therapy in eight trials or to modified constraint-induced movement therapy in one trial. The other trials provided neurofeedback to support MP: MP-guided neuromuscular electrical stimulation (NMES) in four trials and MP-guided robot-assisted therapy (RAT) in two trials. MP added to conventional therapy resulted in significantly higher FMA gain than conventional therapy alone. MP-guided NMES showed superior result than conventional NMES as well. However, the FMA gain of MP-guided RAT was not significantly higher than RAT alone. We suggest that MP is an effective complementary therapy either given with neurofeedback or not. Neurofeedback applied to MP showed different results depending on the therapy provided. This study has limitations because of heterogeneity and inadequate quality of trials. Further research is requested.

Processed Electroencephalogram Monitoring and Postoperative Delirium: A Systematic Review and Meta-analysis.

Postoperative delirium complicates approximately 15 to 20% of major operations in patients at least 65 yr old and is associated with adverse outcomes and increased resource utilization. Furthermore, patients with postoperative delirium might also be at risk of developing long-term postoperative cognitive dysfunction. One potentially modifiable variable is use of intraoperative processed electroencephalogram to guide anesthesia. This systematic review and meta-analysis examines the relationship between processed electroencephalogram monitoring and postoperative delirium and cognitive dysfunction.

How Much Does Education Improve Intelligence? A Meta-Analysis.

Intelligence test scores and educational duration are positively correlated. This correlation could be interpreted in two ways: Students with greater propensity for intelligence go on to complete more education, or a longer education increases intelligence. We meta-analyzed three categories of quasiexperimental studies of educational effects on intelligence: those estimating education-intelligence associations after controlling for earlier intelligence, those using compulsory schooling policy changes as instrumental variables, and those using regression-discontinuity designs on school-entry age cutoffs. Across 142 effect sizes from 42 data sets involving over 600,000 participants, we found consistent evidence for beneficial effects of education on cognitive abilities of approximately 1 to 5 IQ points for an additional year of education. Moderator analyses indicated that the effects persisted across the life span and were present on all broad categories of cognitive ability studied. Education appears to be the most consistent, robust, and durable method yet to be identified for raising intelligence.

Procedural sensitivities of effect sizes for single-case designs with directly observed behavioral outcome measures.

A wide variety of effect size indices have been proposed for quantifying the magnitude of treatment effects in single-case designs. Commonly used measures include parametric indices such as the standardized mean difference as well as nonoverlap measures such as the percentage of nonoverlapping data, improvement rate difference, and nonoverlap of all pairs. Currently, little is known about the properties of these indices when applied to behavioral data collected by systematic direct observation, even though systematic direct observation is the most common method for outcome measurement in single-case research. This study uses Monte Carlo simulation to investigate the properties of several widely used single-case effect size measures when applied to systematic direct observation data. Results indicate that the magnitude of the nonoverlap measures and of the standardized mean difference can be strongly influenced by procedural details of the study's design, which is a significant limitation to using these indices as effect sizes for meta-analysis of single-case designs. A less widely used parametric index, the log response ratio, has the advantage of being insensitive to sample size and observation session length, although its magnitude is influenced by the use of partial interval recording. (PsycINFO Database Record

Intra- and postoperative intravenous ketamine does not prevent chronic pain: A systematic review and meta-analysis.

Background and aims The development of postoperative chronic pain (POCP) after surgery is a major problem with a considerable socioeconomic impact. It is defined as pain lasting more than the usual healing, often more than 2-6 months. Recent systematic reviews and meta-analyses demonstrate that the N-methyl-D-aspartate-receptor antagonist ketamine given peri- and intraoperatively can reduce immediate postoperative pain, especially if severe postoperative pain is expected and regional anaesthesia techniques are impossible. However, the results concerning the role of ketamine in preventing chronic postoperative pain are conflicting. The aim of this study was to perform a systematic review and a pooled analysis to determine if peri- and intraoperative ketamine can reduce the incidence of chronic postoperative pain. Methods Electronic searches of PubMed, EMBASE and Cochrane including data until September 2013 were conducted. Subsequently, the titles and abstracts were read, and reference lists of reviews and retrieved studies were reviewed for additional studies. Where necessary, authors were contacted to obtain raw data for statistical analysis. Papers reporting on ketamine used in the intra- and postoperative setting with pain measured at least 4 weeks after surgery were identified. For meta-analysis of pain after 1, 3, 6 and 12 months, the results were summarised in a forest plot, indicating the number of patients with and without pain in the ketamine and the control groups. The cut-off value used for the VAS/NRS scales was 3 (range 0-10), which is a generally well-accepted value with clinical impact in view of quality of life. Results Our analysis identified ten papers for the comprehensive meta-analysis, including a total of 784 patients. Three papers, which included a total of 303 patients, reported a positive outcome concerning persistent postsurgical pain. In the analysis, only one of nine pooled estimates of postoperative pain at rest or in motion after 1, 3, 6 or 12 months, defined as a value ≥3 on a visual analogue scale of 0-10, indicated a marginally significant pain reduction. Conclusions Based on the currently available data, there is currently not sufficient evidence to support a reduction in chronic pain due to perioperative administration of ketamine. Only the analysis of postoperative pain at rest after 1 month resulted in a marginally significant reduction of chronic postoperative pain using ketamine in the perioperative setting. Implications It can be hypothesised, that regional anaesthesia in addition to the administration of perioperative ketamine might have a preventive effect on the development of persistent postsurgical pain. An additional high-quality pain relief intra- and postoperatively as well after discharge could be more effective than any particular analgesic method per se. It is an assumption that a low dose infusion ketamine has to be administered for more than 72 h to reduce the risk of chronic postoperative pain.

Prevalence of Self-Reported Intimate Partner Violence Victimization Among Military Personnel: A Systematic Review and Meta-Analysis.

Research on intimate partner violence (IPV) in the military has tended to focus on military personnel as perpetrators and civilian partners/spouses as victims. However, studies have found high levels of IPV victimization among military personnel. This article systematically reviews studies of the prevalence of self-reported IPV victimization among military populations.

Do low-dose corticosteroids improve survival or shock reversal from septic shock in adults? Meta-analysis with trial sequential analysis.

Objective This meta-analysis with trial sequential analysis (TSA) was performed to determine whether low-dose corticosteroids (LDCs) can improve survival or shock reversal from septic shock in adults. Methods A literature search was performed using several databases (Medline, Cochrane Library, Embase, and Chinese Biological Medical Database) until 23 October 2017. The systematic review was registered in PROSPERO. Results Nine randomized controlled trials (RCTs) (n = 1182) were included. LDC intervention improved 7-day shock reversal compared with the control group (relative risk, 1.36; TSA-adjusted 95% confidence interval, 1.20-1.54). LDCs had no statistically significant effects on gastrointestinal bleeding or superinfection. LDCs did not reduce 28-day mortality from septic shock (relative risk, 0.96; TSA-adjusted 95% confidence interval, 0.74-1.24). The TSA indicated that RCTs of about 3000 patients would be needed to draw definitive conclusions; similar results were obtained in a subgroup analysis of nonresponders. Conclusions LDCs improve 7-day shock reversal. However, whether LDCs improve 28-day survival from septic shock in adults remains unclear. The results of well-designed larger RCTs are needed.

Attention control comparisons with SLT for people with aphasia following stroke: methodological concerns raised following a systematic review.

Attention control comparisons in trials of stroke rehabilitation require care to minimize the risk of comparison choice bias. We compared the similarities and differences in SLT and social support control interventions for people with aphasia.